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This makes it really important to follow your doctor’s advice closely and be careful if you’re taking benzos for a long time. The risk of misuse and the problems that come with it show why you need to be cautious with long-term benzo therapy. Deciding to seek help is the first step on your journey to reclaiming your life from addiction. Whether you’re dealing with benzodiazepine withdrawal or seeking freedom from other substances, our comprehensive detox programs are designed to provide the care and support you need to move forward with confidence.
Coping with protracted symptoms
Voluntary tranquilliser support groups (self-help groups) can be extremely helpful. They are usually run by people who have been through withdrawal and therefore understand the time and patience required, and can provide information about benzodiazepines. It can be encouraging to find that you are not alone, that there are plenty of others with similar problems to yours. However, do not be misled into fearing that you will get all the symptoms described by the others. Everyone is different and some people, with the right schedule and the right support, get no untoward symptoms at all.
- There are many measures that will alleviate these symptoms, such as muscle stretching exercises as taught in most gyms, moderate exercise, hot baths, massage and general relaxation exercises.
- Ideally, your mentor should be someone who understands about benzodiazepine withdrawal or is prepared to read about it and learn.
- They enhance the neurotransmitter GABA’s effect in the brain, which results in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties.
- Benzodiazepines, which are classified as Schedule IV controlled substances by the DEA, are prescribed for a range of conditions like insomnia, anxiety, panic disorders, seizures, and muscle spasms.
- Millions of people take benzodiazepines every year, all of whom are at risk of developing an addiction.
- In both cases the phenomena may herald the beginning of a return in normal memory functions and, although sometimes disturbing, can be welcomed as a sign of a step towards recovery.
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Research showed that 40% of people taking benzos for longer than 6 months experienced moderate-to-severe withdrawal symptoms. Benzodiazepine, or benzo, withdrawal happens when a person suddenly stops taking benzodiazepine drugs, which doctors do not recommend. The withdrawal symptoms, which vary in severity, typically begin within 24 hours and may last from a few days to a few months. Withdrawing from benzodiazepines can be a physically and emotionally complex process.
16 Treatment: Medication + Modality
Uncomfortable withdrawal symptoms can result if a person suddenly stops using benzos or drastically reduces use. The first withdrawal symptoms begin during this period for people who use longer-acting benzos. Medically supervised detox includes tapering down the dosage of benzodiazepines. There are many symptoms that can be experienced during benzodiazepine withdrawal. For a more comprehensive list that was compiled from existing lists and contributions from people experiencing benzodiazepine withdrawal themselves, click here. Alcohol Use Disorder Rather than (or in addition to) expensive therapists, you need someone reliable, who will support you frequently and regularly, long-term, both during withdrawal and for some months afterwards.
Protracted withdrawal, also known as post-acute withdrawal syndrome (PAWS), refers to a subset of withdrawal symptoms that persist for months, or even years, after stopping benzodiazepines. While acute withdrawal symptoms are intense and predominantly physical, protracted withdrawal symptoms can be more subtle, chronic, and often more psychological in nature. Benzodiazepine withdrawal is a series of physical, emotional and behavior changes experienced when a person tries to reduce its dose or cease taking a benzodiazepine like Xanax, Klonopin, Ativan, Diazepam, Librium or Onfi. When a person becomes physically dependent on benzodiazepines their body and brain become so accustomed to having the drug that they will experience withdrawal symptoms when you cut down the dose or stop the drug. Many people taking benzodiazepines long-term have also been prescribed antidepressant drugs because of developing depression, either during chronic use or during withdrawal. Antidepressant drugs should also be tapered slowly since they too can cause a withdrawal reaction (euphemistically labelled “antidepressant discontinuation reaction” by psychiatrists).
Many people in fact have managed to come off on their own without any outside help. It is a good idea to make out a dosage reduction schedule for the initial stages (see below) and to give your doctor a copy. You may need to mention the importance of flexibility, so that the rate of dosage tapering can be amended at any time. There may even be circumstances when you need to stop for a while at a certain stage. A continuation schedule can follow later depending upon how you get on, and the doctor can continue prescribing in accordance with the new schedule. If withdrawal symptoms become severe, doctors may prescribe other medications.
This benzodiazepine is eliminated so quickly (half-life 2 hours) that you are practically withdrawn each day, after a dose the night before. For this reason, triazolam can be stopped abruptly without substitution of a long-acting benzodiazepine. If withdrawal symptoms occur, you could take a short course of diazepam starting at about 10mg, decreasing the dosage as shown on Schedule 2. The same approach applies to the non-benzodiazepines zolpidem and zaleplon which both have half-lives of 2 hours.
There is no need to avoid ordinary pain killers such as Tylenol, Feldene etc. for everyday aches and pains. Once started on an antidepressant for depression, the treatment should be continued for some months (usually about 6 months) to avoid recurrence of the depression. Benzodiazepine tapering can continue during this time, and the antidepressant will sometimes act as a welcome umbrella during the last stages of withdrawal. It is important to finish the benzodiazepine withdrawal before starting to withdraw the antidepressant.
Benzodiazepine withdrawal
- People who have been on low doses of benzodiazepine for a relatively short time (less than a year) can usually withdraw fairly rapidly.
- With this knowledge, patients and healthcare providers can develop strategies to navigate withdrawal with greater safety and comfort.
- Since GABA is an inhibitory transmitter,which slows or stops the firing of other neurotransmitters, by increasing GABAactivity you quiet the brain’s overall activity level.
- Medical supervision ensures the safety and health of the individual during the withdrawal process, helping to manage symptoms, adjust the tapering schedule as needed, and provide support and reassurance.
- All the studies show steady, if slow, improvement in cognitive ability and physical symptoms.
A characteristic feature of benzodiazepine withdrawal is a heightened sensitivity to all sensations – hearing, sight, touch, taste and smell. One lady had to stop all the clocks in the house because their ticking sounded unbearably loud; many have had to don dark glasses because ordinary light seemed dazzlingly bright. Some find that the skin and scalp becomes so sensitive that it feels as if insects are crawling over them. Heartbeats become audible and there may be a hissing or ringing sound in the ears (tinnitus – see below). Many people complain of a metallic taste in the mouth and several notice strange, unpleasant, smells which seem to emanate from the body.
After that first leap, the steps become smaller, usually 5% to 10% of the original dose. alcoholism Depending on your situation, your doctor may reduce your dose on a monthly, weekly, or even daily basis. You may have to pause, slow down, or speed up depending on how your body reacts to withdrawal. For example, say you’re tapering off a dose of 20 milligrams (mg) of diazepam (Valium).
Physiological dependence on benzodiazepines can occur following prolonged treatment with therapeutic doses, but it is not clear what proportion of patients are likely to experience a withdrawal syndrome. It is also unknown to what extent the risk of physiological dependence is dependent upon a minimum duration of exposure or dosage of these drugs. Withdrawal phenomena appear to be more severe following withdrawal from high doses or short-acting benzodiazepines.
Quite often, people taking long-term benzodiazepines are already taking an antidepressant as well. In this case they should stay on the antidepressant until the benzodiazepine withdrawal is complete. The need for sleep is so powerful that normal sleep will eventually reassert itself. Meanwhile, attention to sleep hygiene measures including avoiding tea, coffee, other stimulants or alcohol near bedtime, relaxation tapes, anxiety management techniques and physical exercise may be helpful. Taking all or most of the dose of benzodiazepine at night during the reduction period may also help. Occasionally another drug might be indicated (see section on adjuvant drugs, below).
Neither antidepressants nor antihistamines act by the same mechanisms as benzodiazepines. All sorts of strange tinglings, pins and needles, patches of numbness, feelings of electric shocks, sensations of hot and cold, itching, and deep burning pain are not uncommon during benzodiazepine withdrawal. It is difficult to give an exact explanation for these sensations but, like motor nerves, the sensory nerves, along with their connections in the spinal cord and brain, become hyperexcitable during withdrawal. It is possible that sensory receptors in skin and muscle, and in the tissue sheaths around bones, may fire off impulses chaotically in response to stimuli that do not normally affect them.
